Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-18T13:08:52.428Z Has data issue: false hasContentIssue false

A review: Percutaneous pulmonary artery stenosis therapy: state-of-the-art and look to the future

Published online by Cambridge University Press:  27 December 2018

Anuj B. Patel*
Affiliation:
Division of Cardiology, Boston Children’s Hospital, Boston, MA, USA
Kanishka Ratnayaka
Affiliation:
Division of Cardiology, Rady Children’s Hospital, San Diego, CA, USA
Lisa Bergersen
Affiliation:
Division of Cardiology, Boston Children’s Hospital, Boston, MA, USA
*
Author for correspondence: A. Patel, MSc, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Tel: (978) 821-8016; E-mail: apatel20@une.edu

Abstract

Stenosis, or narrowing, of the branches of the pulmonary artery is a type of CHD that, if left untreated, may lead to significant complications. Ideally, interventions to treat stenosis occur before significant complications or long-term sequelae take place, often within the first 2 years of life. Treatment depends on specifics of the condition, the presence of other malformations, and age of the child. Research and recent innovation to address these shortcomings have provided physicians with safer and more effective methods of treatment. This has further continued to push the ceiling of pulmonary arterial stenosis treatment available for patients. Despite continuous advancement in angioplasty – such as conventional and cutting balloon – and stenting, each treatment method is not without its unique limitations. New technological developments such as bioresorbable stents can accommodate patient growth and pulmonary artery stenosis treatment. As more than a decade has passed since the review by Bergersen and Lock, this article aims to provide a contemporary summary and investigation into the effectiveness of various therapeutic tools currently available, such as bare metal stents and potential innovations including bioresorbable stents.

Type
Review Article
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Patel AB, Ratnayaka K, Bergersen L. (2018). A review: Percutaneous pulmonary artery stenosis therapy: state-of-the-art and look to the future. Cardiology in the Young page 93 of 99. doi: 10.1017/S1047951118001087

References

1. Bacha, EA, Kreutzer, J. Comprehensive management of branch pulmonary artery stenosis. J Interv Cardiol 2001; 14: 367375.10.1111/j.1540-8183.2001.tb00346.xGoogle Scholar
2. Bergersen, L, Lock, J. What is the current option of first choice for treatment of pulmonary artery stenosis. Cardiol Young 2006; 16: 329338.10.1017/S1047951106000679Google Scholar
3. Lock, J, Niemi, T, Einzig, S, et al. Transvenous angioplasty of experimental branch pulmonary artery stenosis in newborn lambs. Circulation 1981; 64: 886893.10.1161/01.CIR.64.5.886Google Scholar
4. Kan, J, Marvin, W, Bass, J, et al. Balloon angioplasty – branch pulmonary artery stenosis: results from the Valvuloplasty and Angioplasty of Congenital Anomalies Registry. Am J Cardiol 1990; 65: 798801.10.1016/0002-9149(90)91391-IGoogle Scholar
5. Mullins, C, O’Laughlin, M, Vick, G, et al. Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries. Circulation 1988; 77: 188199.10.1161/01.CIR.77.1.188Google Scholar
6. Feltes, T, Bacha, E, Beekman, R III, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011; 123: 26072652.10.1161/CIR.0b013e31821b1f10Google Scholar
7. Davies, G, Reid, L. Growth of alveoli and pulmonary arteries in childhood. Thorax 1970; 25: 669681.10.1136/thx.25.6.669Google Scholar
8. Trant, CA Jr, O’Laughlin, MP, Ungerleider, RM, Garson, A Jr. Cost-effectiveness analysis of stents, balloon angioplasty, and surgery for the treatment of branch pulmonary artery stenosis. Pediatr Cardiol 1997; 18: 339344.10.1007/s002469900195Google Scholar
9. Bergersen, L, Lock, J. Pulmonary artery stenosis, angioplasty, stenting, or cutting balloon: what is the current treatment of first choice? A review. Cardiol Young 2006; 16: 329338.10.1017/S1047951106000679Google Scholar
10. Holzer, R, Beekman, R, Benson, L, et al. Characteristics and safety of interventions and procedures performed during catheterization of patients with congenital heart disease: early report from the National Cardiovascular Data Registry. Cardiol Young 2016; 26: 12021212.10.1017/S1047951115002218Google Scholar
11. Holzer, R, Gauvreau, K, Kreutzer, J, et al. Balloon angioplasty and stenting of branch pulmonary arteries. Circ Cardiovasc Interv 2011; 4: 287296.10.1161/CIRCINTERVENTIONS.110.961029Google Scholar
12. Bergersen, L, Justino, H, Nugent, A, et al. A randomized trial of cutting balloon compared to high pressure angioplasty for the treatment of resistant pulmonary artery stenosis. Circulation 2011; 124: 23882396.10.1161/CIRCULATIONAHA.111.018200Google Scholar
13. Gentles, T, Lock, J, Perry, S. High pressure balloon angioplasty for branch pulmonary artery stenosis: early experience. J Am Coll Cardiol 1993; 22: 867872.10.1016/0735-1097(93)90205-FGoogle Scholar
14. Zeevi, B, Berant, M, Blieden, L. Midterm clinical impact versus procedural success of balloon angioplasty for pulmonary artery stenosis. Ped Cardiol 1997; 18: 101106.10.1007/s002469900125Google Scholar
15. Bush, D, Hoffman, T, Del Rosario, J, et al. Frequency of restenosis after balloon pulmonary arterioplasty and its causes. Am J Cardiol 2000; 86: 12051209.10.1016/S0002-9149(00)01203-0Google Scholar
16. Baker, C, McGowan, F, Keane, J, Lock, J. Pulmonary artery trauma due to balloon dilation: recognition, avoidance and management. J Am Coll Cardiol 2000; 36: 16841690.10.1016/S0735-1097(00)00904-9Google Scholar
17. Bergersen, L, Gauvreau, K, Lock, J, et al. Recent results of pulmonary arterial angioplasty: the differences between proximal and distal lesions. Cardiol Young 2005; 15: 597604.10.1017/S1047951105001769Google Scholar
18. Geggel, R, Gauvreau, K, Lock, J. Balloon dilation angioplasty of peripheral pulmonary stenosis associated with Williams syndrome. Circulation 2001; 103: 21652170.10.1161/01.CIR.103.17.2165Google Scholar
19. Takao, C, Said, H, Connolly, D, Hamzeh, R, Ing, F. Impact of stent implantation on pulmonary artery growth. Catheter Cardiovasc Interv 2013; 82: 445452.10.1002/ccd.24710Google Scholar
20. McElhinney, D, Bergersen, L, Marshall, A. In situ fracture of stents implanted for relief of pulmonary arterial stenosis in patients with congenitally malformed hearts. Cardiol Young. 2008; 18: 405414.10.1017/S1047951108002424Google Scholar
21. Bergersen, L, Gauvreau, K, Marshall, A, et al. Procedure-type risk categories for pediatric and congenital cardiac catheterization. Circ Cardiovasc Interv 2011; 4: 188194.10.1161/CIRCINTERVENTIONS.110.959262Google Scholar
22. Moore, J, Vincent, R, Beekman, R, et al. Procedural results and safety of common interventional procedures in congenital heart disease: initial report from the National Cardiovascular Data Registry. J Am Coll Cardiol 2014; 64: 24392451.10.1016/j.jacc.2014.09.045Google Scholar
23. Angtuaco, M, Sachdeva, R, Jaquiss, R, et al. Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease. Catheter Cardiovasc Interv 2011; 77: 395399.10.1002/ccd.22797Google Scholar
24. Shaffer, KM, Mullins, CE, Grifka, RG, et al. Intravascular stents in congenital heart disease: shortand long-term results from a large single-center experience. J Am Coll Cardiol 1998; 31: 661667.10.1016/S0735-1097(97)00535-4Google Scholar
25. Maglione, J, Bergersen, L, Lock, J, McElhinney, D. Ultra-high-pressure balloon angioplasty for treatment of resistant stenoses within or adjacent to previously implanted pulmonary arterial stents. Circ Cardiovasc Interv 2009; 2: 5258.10.1161/CIRCINTERVENTIONS.108.826263Google Scholar
26. Sigler, M, Schneider, K, Meissler, M, et al. Breakable stent for interventions in infants and neonates: an animal study and histopathological findings. Heart 2006: 92245.Google Scholar
27. Ewert, P, Peters, B, Nagdyman, N, et al. Early and mid-term results with the Growth Stent – a possible concept for transcatheter treatment of aortic coarctation from infancy to adulthood by stent implantation? Catheter Cardiovasc Interv 2008; 71: 120.10.1002/ccd.21397Google Scholar
28. Ewert, P, Riensenkampff, E, Neuss, M, et al. Novel growth stent for the permanent treatment of vessel stenosis in growing children: an experimental study. Catheter Cardiovasc Interv 2004; 62: 506.10.1002/ccd.20136Google Scholar
29. Ing, FF, Fagan, TE, Kearny, DL, Mullins, CE. The new “open-ring” stent: evaluation in a swine model. Catheter Cardiovasc Interv 1998; 44: 109.Google Scholar
30. Shibbani, K, Kenny, D, McElhinney, D, et al. Identifying gaps in technology for congenital interventions: analysis of a needs survey from congenital interventional cardiologists. Pediatr Cardiol 2016; 37: 925.Google Scholar
31. Zartner, P. First successful implantation of a biodegradable metal stent into the left pulmonary artery of a preterm baby. Catheter Cardiovasc Interv 2005; 66: 590.10.1002/ccd.20520Google Scholar
32. Castro Rodriguez, J. Implantation of an absorb bioresorbable vascular scaffold in the stenotic aortopulmonary collateral artery of a young child with Alagille syndrome. Catheter Cardiovasc Interv 2015; 86: E76.Google Scholar
33. McCrossan, BA. First reported use of drug-eluting bioabsorbable vascular scaffold in congenital heart disease. Catheter Cardiovasc Interv 2016; 87: 324.Google Scholar
34. Picture made available through 480 Biomedical Inc.Google Scholar
35. Alexy, R, Levi, D. Materials and manufacturing technologies available for production of a pediatric bioabsorbable stent. Biomed Res Int 2013; 2013: 137985.Google Scholar
36. Core, L. IGF::OT::IGF SBIR Topic 079 Phase I – Bioabsorbable stents for pediatric pulmonary. Retrieved January 3, 2018, from https://sbirsource.com/sbir/awards/160462-igf-ot-igf-sbir-topic-079-phase-i-bioabsorbable-stents-for-pediatric-pulmonary.Google Scholar